Proper billing of 97530

Proper billing of 97530

I have a chiropractic client who is going to start billing 97530 x 3 units. This is going to be for a total of 45 minutes. Should I use a modifier to indicate prolonged time or just indicate 3 units with this code. (and of course, be prepared to provide supporting documentation when it gets denied!)

We just bill the units no modifier. However, we "clock" the patient in and out with a punch clock to document actual therapy time. You would also need to have the rep's, activities etc performed. That's at least 38 minutes of therapeutic activities.

I would watch the documentation. We do alot of 97110 but little to no 97530. There's a seminar going around advocating this type of coding.

As long as you can document the time for 3 units, you should have no problems. There is no modifier (I'm assuming you meant -22). I have one client who bills multiple units on occasion but is very careful to document the activities performed and the time taken. I don't see too much of 97530 billed out; my clients use more of 97535 or 97537.

There is a seminar circulating around that is advocating some interesting coding variations--I dont remember the name off the top of my head.

I have taken a records review course and they discussed how this coding gets flagged on some of the more interesting interpretations of the codes. For example billing flexion/distraction as a 97530 (it's dynamic, it's direct contact and it will improve joint function--functional performance) or massage therapy under 97112.

Hmmm-I'll have to keep my eye out for that one. All the seminar instructors seem to say that "as long as you document, document, document, it will hold up in review." I always say that one knows right away if an interpretation of a code is "stretching" it.

Thanks everyone for your responses. Actually, I was referring to modifier -21, prolonged E&M services, but I suppose -22 would make sense as well. At any rate, this doctor will be billing 97530 along with 98942, 97032 and 97010. I will try it with just 3 units. This client is very good about documentation, so I'm comfortable that we will be able to successfully appeal should the need arise.